Chetcuti P, Myers N A, Phelan P D, Beasley S W, Dickens D R
Department of Paediatrics, University of Melbourne, Australia.
J Pediatr Surg. 1989 Mar;24(3):244-7. doi: 10.1016/s0022-3468(89)80003-x.
Chest wall deformities developed after thoracotomy for esophageal atresia, in 77 of 232 patients (33%) who did not have a congenital vertebral anomaly. Anterior chest wall asymmetry was present in 47, scoliosis in 18 and a combination of both in 12 patients. Scoliosis was convex away from the incision in two thirds of those affected. Anterior chest wall deformity was more common in patients greater than 25 years of age, and scoliosis was more common in patients who had had multiple thoracotomies. Breast surgery to minimize inequality was required in three female patients, and spinal surgery in one patient. Twenty-two of 53 patients with a congenital vertebral anomaly developed scoliosis, eight of whom required surgery. The scoliosis was probably the result of the vertebral anomaly in these patients, who are particularly at risk for progressive deformity.
在232例无先天性椎体异常的食管闭锁患者中，77例（33%）在开胸术后出现胸壁畸形。47例存在前胸壁不对称，18例有脊柱侧弯，12例两者并存。三分之二的脊柱侧弯患者凸侧远离切口。前胸壁畸形在25岁以上患者中更常见，脊柱侧弯在接受多次开胸手术的患者中更常见。3例女性患者需要进行乳房手术以减少不对称，1例患者需要进行脊柱手术。53例有先天性椎体异常的患者中，22例出现脊柱侧弯，其中8例需要手术。这些患者的脊柱侧弯可能是椎体异常的结果，他们尤其有发生渐进性畸形的风险。
